Why Talk Therapy Fails

Oh, the insanity! Over the years numerous mental health professionals engaged my children in traditional talk therapy – even after I raised concerns. They somehow thought the approach would work.

Don’t allow them to rehash the past. They already have.

Don’t allow them to blame others. They need to focus on accountability.

Don’t allow them to pit me against other adults. They know how to triangulate.

In other words, don’t allow my kids to take over your session. Don’t play into their anxiety. And don’t allow them to create a mess that I will be left to untangle once you step out the door.

Firm boundaries matter – especially for children, teens and young adults with a history of early trauma or FASD.

Nonetheless, the insanity continued during therapy sessions. Soon it intensified.

Early on in my parenting journey, a wise friend offered clear advice, “Never let your children meet with a mental health professional alone, at least initially.” Those words proved to be some of the best advice I ever heard – which allowed me to experience the session first hand.

With that being said, parents also have a responsibility to remain positive, if included in their child’s session. No shaming allowed. That includes the parent shaming the child in front of the therapist OR the therapist shaming the parent in front of the child.

On the immediate surface, my kids appear cognitively and emotionally aware to a new therapist. Because they have decent vocabularies. Because they have discussed their diagnoses with me. Because they possess basic knowledge. Because they desire to self-advocate – after observing me advocate for them.

And because they mimic me-the parent who has supported for them at home, the teachers at school and others in the community.

But let’s be real.

I’m talking about a trainload of “mis-truths, half-truths and sort-of-truths” emanating from my children’s mouths. Most involve me and my parenting. Many are not flattering. None are entirely true.

Note that I didn’t say lies. From their limited perspective which originates within an underdeveloped or disorganized brain, they are spewing fact – not fiction.

Disappointing? Yes!

Frustrating? Without question!

Exhausting? Don’t get me started!

Although I knew better than to take my children’s comments personally, the words still cut to the bone. I’m human after all and felt each dagger. That’s when the rationale side of me kicked into full gear – wanting to talk through the issue. Perceptions can trump reality.

That’s when I finally saw my reality. Open-ended talking during a therapy session doesn’t work for most individuals with early trauma. It’s a well-intended invitation to the wrong party. And without the necessary boundaries, it triggers relentless control – before erupting into a debate that no parent or reasonable adult can win.

So why does talk therapy fail so miserably?

With many mental health conditions that began at birth or shortly thereafter, the brain short circuits in a variety of ways.

1-Processing language might be hit or miss.

2-Accessing short-term and long-term memories might be difficult.

3-Sequencing events in the right order might be impossible.

With that basic knowledge of the brain, why on earth would mental health professionals actively engage their clients in talk therapy? It’s certainly not “best practice.” And in most cases, the talk causes harm than good.

Enabling through blame never sustains outcomes.

No wonder many parents feel compelled to stop therapy altogether. They probably have the wrong person serving an incredibly important role.

The next question is obvious. Can therapy truly work? Of course it can! The answer lies in the professional’s approach – which should be openly discussed with the parent before meeting with the child or teen.

Here are five successful interventions that I’ve witnessed firsthand with my own children. None rely exclusively on talk.

Identification of Personal Strengths – not less than five. Many children regularly hear what they do wrong, not what they do right (which doesn’t mean doing something perfectly). Knowing one’s strengths is the basis for improved self-esteem. And the vast majority of our kids have little to none.

Specific skill building – the more hands-on the better, especially when done in the community. Asking questions, interpreting others’ emotions, thinking before reacting and managing over-stimulation in real time are all possibilities. Practice instills good habits – a process called habilitation. As social awareness increases, self-confidence does too.

Visualization – in a park, museum or other visually stimulating environment. Everyday images can make powerful connections in the brain with guidance from a professional. Those connections (or visual maps) enhance positive perception. They also reduce or replace the negative effects from past trauma.

Meaningful Projects – from start to completion. Preparing a meal. Learning a craft. Volunteering with people or animals. Positive coaching is a must with the goal of transferring the same role to the parent. In turn, the child learns to accept feedback – both appropriate praise and constructive redirection.

Future Thinking – not next year but next week. Discussing strategies for upcoming events at home or school reduces anxiety and allows problem solving. Role playing before the fact never hurts. Another adult says the same thing as the parent.

And one more thing. Three simple ground rules are imperative for every session – with the mental health professional enforcing them to reduce the likelihood of triangulation.

1-NO questioning adult authority, especially the parent or primary caregiver. If necessary, the therapist/behavior clinician can discuss matters privately with mom or dad.

2-NO reliving the past exclusively. The focus must remain on the present.

3-NO relying on emotions in the absence of fact. Rationale thought must be emphasized with the therapist/behavior clinician – rather than the client – guiding the conversation.

Now let’s summarize this simple lesson.

Skip the traditional talk.

Instead, jump into meaningful action and create an appropriate dialogue.

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11 thoughts on “Why Talk Therapy Fails”

Reblogged this on Fighting for Answers and commented:
I can’t begin to tell you the damage that occurs when a child with severe mental illness triangulates a therapist against parents. If you are a mental health professional, please read this. It is so important!

Wow – you articulated this so well. Have you looked into the Feuerstein Program (from Israel). It is action oriented, “do” instead of more yak. builds cognitive skills that support the social-emotional growth in teen and adults. Very good stuff! More info at mind-cap.org
Blessings – Jeanne

Thank you. I have spent a couple of years researching therapy. First of all, trying to sort out what different kinds are available. Next, trying to figure out which (if any) might help my daughter. Third, trying to find someone in my area who offers trauma-informed therapy of any kind. Fourth, hoping to find someone we like and feel safe with. It seems hopeless sometimes. We have just started with an EMDR therapist we found, but so far my daughter doesn’t like her. I don’t know what to do.

On a positive note, she went to the session. Hopefully, she will feel more comfortable next time. Feeling safe and trusting the therapist make EMDR more productive. DBT can work well in conjunction with EMDR.

Your article is so very well articulated. Thank you. I always focused on what Nathaniel Brandon outlined in his book Pillars of self esteem. You nailed it as well, competency in something increases self esteem. Being able to care for oneself increases self esteem. Great article and advice. Thank you.